Q: How are eating disorders classified and what are the conventional treatments?
Reed Robison, M.D.: I have an eating disorder and I have an eating disorder that affects many people. Full-blown eating disorders are therefore estimated to affect more than 30 million Americans living with an eating disorder. Examples include anorexia, bulimia, bulimia, etc. In fact, she is the third most common chronic condition among adolescent females (I think). However, the COVID-19 pandemic appears to have increased this prevalence and highlighted the need for treatment. We have also seen the incidence of eating disorders in certain populations rise by 10% or 20% or more in recent years. And some studies have doubled the number of people seeking treatment. Eating disorders are complex illnesses with biological, social, cultural, and environmental components that carry a high risk.
Q: Has the COVID-19 pandemic affected this disease?
Reed Robison, M.D.: I think this is comparable to depression, anxiety and increased drug use. It kind of rocked and triggered our underlying mental health vulnerabilities so much. -and the associated urgent need for treatment.
Q: In your opinion, what are the current barriers to treating this disorder, especially among young women?
Reed Robison, M.D.: These are serious, with an estimated one death every hour worldwide as a direct result of eating disorders. And eating disorders have the highest mortality rate of any mental illness. However, conditions like anorexia nervosa do not have FDA-approved drugs as an option to treat them. There is a cure, but there is also much work to be done. And the barriers to treatment are difficult. Our culture and social constructs, as well as socioeconomic factors, come into play. Therefore, from a cultural and social perspective, the most well-known environmental factor that develops eating disorders is what can be called the “lean beauty ideal” or the idealization of socio-cultural sophistication. It is deeply ingrained in and unshakable. By the age of six, we see a young girl begin to voice her concerns about her weight and figure. For example, more than half of elementary school girls acknowledge their concerns about weight and being overweight. This is permanent, permanent. And combine that with both the stigma that has been there for decades about seeking mental health help.The challenge we have is eating disorders with early detection. For example, if you had cancer, you couldn’t imagine that your doctor or healthcare system would say, “Your cancer is stage 1. Come back when it’s staged.” 2 or 3. But it has been done to people with eating disorders. These are serious conditions. Early intervention can be very helpful, but when people walk in they either don’t recognize it or they get a message from the system (often the health insurance company) that they aren’t sick enough. When weight loss progresses or when there are more medical consequences, you should come back. But you know, I really believe that when it comes to recognizing and treating eating disorders, we need to have a sense of urgency about them.
Q: It’s pretty distressing that such young people are voicing these problems…
Reed Robison, M.D.:On the one hand, there are concerns about obesity and its effects on medical and mental health, so caution is warranted. We have food culture. A teenage girl diets regularly, and a dieting woman is at least 10 times more likely to bulimia than she is. It is estimated that one-third of her dieters go on to so-called ‘eating disorders’ or ‘pathological diets’. And perhaps 25% or more will develop a full-blown eating disorder.
Q: What is the importance of ketamine in current psychotherapy?
Reed Robison, M.D.: Eating disorders require you to insert self-awareness into the mix. People don’t choose eating disorders. No one wakes up and says, “I want to be anorexic.” Or if someone says so, it’s either not what they meant or you’re seriously misinformed. That is why we need interventions that are more than just a band-aid approach to treating symptoms, such as numbing anxiety. If you have an underlying anxiety disorder, you need to find out the root cause. If trauma is the cause, trauma healing should be done. And these are serious diseases that require intensive care. But on the bright side (thankfully), even deeply ingrained patterns and behaviors (learned) can be forgotten. It just takes time. And given that psychedelic drugs are ‘therapeutic enhancers’, they have become important tools to help individuals see in a new light, their relationships with food and their bodies, and perhaps their patterns, behaviors, and behaviors. the rules imposed on oneself regarding food and eating. So in terms of eating disorders, as I said, they are well-intentioned, not choices. A couple of times you may consciously decide to expel, limit, or overexert, but then they become unconscious patterns that take on a life of their own. Psychedelic drugs are increasingly understood as easing the grasp these patterns have on us by creating so-called neuroplastic windows. This is true not only for ketamine, but also for classic hallucinogens such as psilocybin. Be careful, there are more. Much more research is needed to fully understand how psychedelics can help and how best to combine psychedelics with therapy. With that new perspective and flexibility, it can help those who might have been stuck for years to stay stuck.
